Filed under: Safety
Service members should be careful about taking dietary supplements because many of these products contain hidden active ingredients that can result in harmful effects.
The most common types of dietary supplements found to contain “undeclared” ingredients (that is, substances not listed on the label) are those marketed for weight loss, sexual enhancement, and bodybuilding. The Food and Drug Administration (FDA) has identified over 600 tainted dietary supplements. FDA specifically warns against the use of products that claim to be “alternatives” to FDA-approved drugs or “legal” alternatives to anabolic steroids.
Dietary supplements don’t require approval by FDA before being put on the market, and without laboratory testing there is no way to know the contents of a product. If you’re considering a dietary supplement, be sure to check the label to see if the product has been evaluated by an independent third-party organization.
For more information, please visit Operation Supplement Safety (OPSS), including the OPSS High-Risk Supplement List.
An “adverse event” can occur as a result of taking some dietary supplements. Learn how to identify an adverse event from the Operation Supplement Safety (OPSS) FAQ, and find out where you can go to report one. And for healthcare providers, HPRC has a helpful video, “How to probe for dietary supplement use and report adverse events.” (Click on the “Video” tab to access the link.) Documenting adverse events is an essential part of how the Food and Drug Administration (FDA) evaluates potentially dangerous dietary supplements, so it’s very important to report potential problems.
Service members and their families relocate a lot, and moving to a new home is hard enough without adding injury. Here are some tips on how to properly handle heavy objects such as moving boxes and furniture, and how to take care of yourself if you do sustain an injury:
- Wear less-restrictive clothing such as looser-fitting pants or workout clothes.
- Wear closed-toe shoes.
- Take breaks when necessary. Stretching and reassessing your mechanics can help you maintain proper posture when lifting. HPRC has tips on how to maintain flexibility and remove tension in your body.
- The U.S. Army has fact sheets on Lifting Techniques for handling heavy objects and How to Safely Perform Pushing and Pulling Tasks.
- Remember to keep your core tight, and use your leg muscles rather than your back to lift heavy objects.
The best way to prevent back injury is to strengthen your back and core muscles. The National Institutes of Health (NIH) has suggestions and exercises to help build your back.
If you’re sore from all the lifting or think you may have pulled something, you can treat the pain with ice and rest—and perhaps an over-the-counter pain reliever—for the first 48 hours. Follow NIH guidelines on how to further treat your back pain if it’s acute. However, if the pain persists, consult your doctor to rule out a more serious back problem or injury before you do any more heavy lifting. If all seems well, consider core-strengthening exercises to support your back. Another option is a yoga class to relieve your pain, build your muscles, and return your back to normal function.
For more about how to protect your back, please visit HPRC’s Injury Prevention Series. Good luck with your PCS!
BMPEA is an unapproved amphetamine-like substance that has been appearing in some dietary supplement products. BMPEA (also known as β-methylphenylethylamine, R-beta methylphenylethylamine, beta-methylphenethylamine, and others) was first made in the 1930s as a possible replacement to amphetamine (a central nervous system stimulant), although it never became a drug because human studies on safety were not performed.
The Food and Drug Administration (FDA) tested 21 supplement products with the ingredient Acacia rigidula listed on the label and found that 9 of the 21 products were found to contain BMPEA, which is not derived from the plant Acacia rigidula. Some dietary supplement products actually list BMPEA on their labels. FDA recently issued a warning stating, “…BMPEA does not meet the statutory definition of a dietary ingredient.” Therefore, dietary supplement products with BMPEA are misbranded and cannot be sold as dietary supplements.
The World Anti-Doping Agency has banned BMPEA. For more answers to questions we’ve received about ingredients in dietary supplements, please visit our Operation Supplement Safety (OPSS) FAQs.
Bitter orange is an extract from the immature green fruit of the Citrus aurantium plant, also known as Seville orange. It is sometimes used in small amounts in food as a flavorant and often used in weight-loss supplements. The terms “bitter orange,” “bitter orange extract,” or “Citrus aurantium” are often used interchangeably with the ingredient name “synephrine,” but bitter orange (the extract from Citrus aurantium fruit) is actually a complex mixture of many compounds, including synephrine and octopamine. Although both synephrine and octopamine occur naturally in the Citrus aurantium plant, they also can be made in a laboratory.
Many safety concerns have been raised with regard to synephrine and octopamine, which are both stimulants. The National Collegiate Athletic Association (NCAA) bans both of them, but the World Anti-Doping Agency (WADA) bans only octopamine. Bitter orange is frequently used in "ephedra-free" products since 2004, when the Food and Drug Administration (FDA) banned ephedra for its association with serious adverse cardiovascular effects. Combinations of stimulants—such as bitter orange and caffeine, commonly found together in weight-loss and bodybuilding products—can cause hypertension and increase heart rate in otherwise healthy adults. A major concern with products that list bitter orange (or synephrine, or octopamine) on the label is that the amount of stimulants in the product is sometimes very difficult—if not impossible—to determine. Service members should exercise extreme caution when considering whether to use supplements containing bitter orange.
No conclusive, peer-reviewed, scientific evidence clearly establishes that bitter orange is any safer than ephedra. For more information on bitter orange and ephedra, read the monographs in HPRC’s Dietary Supplement Classification System series.
For more answers to common questions we’ve received about dietary supplements, please visit our Operation Supplement Safety (OPSS) FAQs.
Lately, HPRC has been receiving a lot of questions about the use of banned supplements in the military, but the fact is: There isn’t a list of banned dietary supplements currently available. It isn’t always easy to determine whether a dietary supplement product is safe or not, so the Department of Defense (DoD), together with HPRC, provides helpful resources on the Operation Supplement Safety (OPSS) website to help you choose supplements wisely. With regard to the military’s stance on supplements in general, please see the OPSS FAQ about a "banned list," which is pertinent to all service branches.
Some dietary supplements, including ones sold on military installations, contain potentially harmful and problematic ingredients. For some tips about how to avoid these, read the OPSS infosheet “Red Flags—What You Need to Know.” In addition, some other potentially dangerous ingredients include prescription drug ingredients and their analogs, drugs banned by FDA for safety reasons, controlled substances (such as anabolic steroids), and untested/unstudied new active drug ingredients, which may not be listed on the product label.
One way to ensure that a dietary supplement product is safe is to see if it is third-party verified. Third-party certification organizations have developed criteria for evaluating and authenticating the quality of a supplement—the ingredients, the dosage levels, the level of contaminants, the label claims, and whether the manufacturing facilities follow Good Manufacturing Practices (GMP).
The Natural Medicines Comprehensive Database (NMCD) is the gold standard for evidence-based information on dietary supplement products and ingredients and is an HPRC partner. (Subscription is free if you have a “.mil” email address; visit the OPSS FAQ for more information.) NMCD rates products on a scale of 1 to 10 based on safety and effectiveness. We encourage you to consider only using products rated 8 or above.
To avoid potential problems, talk with your healthcare provider or dietitian before using dietary supplements. Also, see FDA’s list of tainted bodybuilding products, which includes important public notifications.
In a new Operation Supplement Safety (OPSS) PSA video, Gold Star mother Ms. Terri Bellamy-Coleman urges service members to seek out information and guidance on dietary supplements from the appropriate sources before taking them. Ms. Bellamy-Coleman’s son, who was attending the NCO (Noncommissioned Officer Academy, WLC (Warrior Leadership Course) in Fort Benning, GA at the time of his death, had been taking dietary supplements when he exerted himself during physical training, suffered a heart arrhythmia, and died. He had the sickle-cell trait, which may have aggravated the situation. She wants others to be aware of the possible risks associated with dietary supplements, especially when certain medical conditions are present, and urges service members to seek information to help prevent possible harmful health effects. Please watch the video, “A Mother’s Plea."
How do I know if my dietary supplement product contains a stimulant? Are they a potential problem for me? What are peptide hormones and are they safe? Is DMBA the same thing as DMAA? We’ve received many questions on these topics and offer some answers.
Read the newly posted OPSS FAQs for information about:
- How to identify a stimulant
- Stimulants and potential dangers
- Peptide hormones and whether they are safe
- DMBA and why products with it were pulled from stores on bases
And while you’re there, check out the other FAQs in OPSS, which can help answer questions you may have about the safe use of dietary supplements.
It’s important to take the proper safety precautions prevent home fires. The U.S. Fire Administration has some simple but effective tips to prevent home fires and keep you and your family safe.
For some people, eating certain foods can cause serious allergic reactions, even death! The most common food allergens are milk, eggs, fish and shellfish, tree nuts (such as almonds, walnuts, and pecans), peanuts, wheat, and soy. Other food allergies are possible, so it’s important to read food labels for ingredient information if you are at risk. Click here for more information.